Breast Screening

The mammogram

Breast cancer is the most common cancer among women (NHS Breast Cancer Screening Programme - Helping you decide leaflet July 2013). A mammogram is a breast x-ray which can show breast cancers early, when they are too small to see or feel.
 
There are 80 Breast Screening Units (BSU) in England, located within nine regions, each inviting eligible women (aged 50 to 70) through their GP practices. Women are invited to a specialised screening unit, which can be hospital based, mobile, or permanently based in another convenient location such as a shopping centre. Some women talked about the different units they'd been to over the years and how they felt about them. Several stressed the value of having a unit within easy travelling distance, especially because the procedure was usually very quick.

A visit to a screening unit for a routine mammogram takes about half an hour. The woman is greeted by a receptionist or female mammography practitioner who checks her personal details (name, age and address). Most women found staff at the screening unit very friendly, kind and caring. All staff at breast screening units are women and many people said they were pleased about this. One woman said she was Muslim and felt that the invitation letter should stress that all staff are women.

Many women explained that they didn't have to wait long after giving their basic details to a female receptionist, to be called in to have their mammograms. The mammography practitioner asks the woman about any symptoms or history of breast disease, explains what will happen when the mammograms are taken, and answers any questions about breast screening. If the woman is happy to proceed, the mammography practitioner then takes the mammogram. Women are asked to undress to the waist and stand in front of the mammography machine. The radiographer then rests each breast in turn on the x-ray machine and gently but firmly compresses it with a clear plate. The compression only lasts a few seconds and does not cause any harm to the breasts. Compression is needed to keep the breast still and to get the clearest picture with the lowest amount of radiation possible. Two images of each breast are taken so that it can be seen from two different angles.

The radiographer explains when and how the woman will get her results (usually within two weeks), and reminds her of the need to be breast aware between screening appointments. If it is the woman's last routine screening invitation, the mammography practitioner also reminds her that she can ask for another screening appointment in three years' time. 

Most women said that radiographers explained the x-ray procedure to them clearly, particularly if it was their first mammogram. Several said they had felt comfortable asking questions about the procedure and recommended doing so if women were unclear about it. A British Chinese woman said a Chinese organisation had arranged her mammogram appointments for her and had provided an interpreter who explained the whole procedure to her in Cantonese. Two other British Chinese women had gone for breast screening with their daughters, who translated.

A few women suggested that radiographers should give more care and explanation to women coming for their first mammogram. One woman said she would find it helpful if there was a TV screen in the waiting area, giving more information about the breasts, breast care and screening. Another said the radiographer didn't tell her enough, particularly about getting the results. Yet another woman felt that the radiologist was very good but that she was less impressed with the receptionist.

Women may be asked to wait while the films are developed and checked for technical quality. An occasional technical problem may require a repeat x-ray. A few women explained that their breast x-ray had to be re-taken a few minutes after the first x-ray. One woman said that, because of scarring from previous operations for benign (non cancer) conditions, her x-rays often had to be re-taken. Another said that her naturally lumpy breasts sometimes made her mammograms difficult to read.

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Some women are concerned about having mammograms as each mammogram directly exposes the breasts to a small dose of x-rays. However, the tiny risk of these x-rays actually causing any harm to women in the screening age group is far outweighed by the benefits of detecting early breast cancer.

A few women had mammograms done privately rather than on the NHS. One woman, whose mammogram was included in a private health scheme at work, compared her experiences of the procedure in private and NHS screening units. Another, who had mammograms in the United States, discussed some of the differences between standard film and digital mammograms. For one woman, having private mammograms was important because she got the results on the same day rather than waiting for a letter to arrive.

Many women pointed out that there was little waiting around at the screening unit, the whole process taking only about thirty minutes. Before leaving the unit, women are told when they will receive the results.

Last reviewed March 2016.

Last updated March 2016.

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